The American Association of Physicists in Medicine (AAPM) maintains an Online Learning Center (OLC) as a benefit to all of its members. The OLC center can be divided into two parts. The Virtual Library (VL) contains captured presentations from AAPM meetings, schools, and workshops dating back to 2001. These online presentations are a valuable resource for medical physicists needing information or instruction on virtually any topic in medical physics provided by experts in the field. Subjects include diagnostic radiology, nuclear medicine, radiation protection and radiotherapy as well as lectures on medical physics education, professionalism and others. The second part of the OLC is the continuing education (CE) credit and self-assessment (SA) modules. These are quizzes that are linked to either recent VL modules or published scientific papers. When possible, these quizzes are created by the lead speaker or author of the work and peer reviewed by AAPM reviewers. AAPM members may elect to take these quizzes and receive CE credit from CAMPEP as well as SA credit from ABR. These credits are sufficient to fulfill the annual CE and SA requirements for the ABR maintenance of certification. AAPM members can get all of their required credits online for an annual fee of $75 (US). The OLC also offers for purchase thumb drives of special meetings and summer schools the year that they are created. Those individuals who could not attend the meeting but wish to access the content right away can purchase these. In summary, the OLC provides a vast educational resource for the medical physics community.

In today’s highly competitive world, being a good scientist is not sufficient for a professional to prosper; good leadership, managerial and strategic planning skills have become essential. Leadership is of concern to all healthcare professions, but it is even more crucial for small professions such as Medical Physics. Preparing future leaders should be done in two ways: first by direct interaction with successful leaders who would share their experiences (role modelling) and secondly through a formal course in Medical Physics leadership. This presentation will provide examples of both. The author will present his own experiences of leadership and present a practical ‘to do’ list for successful leadership. This will be followed by a description of the leadership module of the EUTEMPE network (MPE01 Leadership in Medical Physics - Development of the profession and the challenges for the Medical Physics Expert http://eutempe-net.eu/modules/) which is presently the most comprehensive module in Medical Physics leadership worldwide. It can be described as a ‘Mini MBA for Medical Physicists’. The module achieves its learning objectives using a combination of online and face-to-face phases. The online component consists of a series of sets of compulsory readings, followed by online discussions involving real world case studies. The online phase is asynchronous so that participants would not need to take time off their clinical duties and there will not be a problem with time zones. This is followed by an onsite phase (one week, first two runs held in Prague February 2015, 2017, next run Prague February 2019 with online phase starting November 2018, applications open). Presentations during the onsite phase are by established leaders and followed by discussions in which participants can discuss challenges they are facing in their own country with a panel of established leaders. Total learning time (readings, presentations, online fora etc) 80 hours.

Medical equipment assessment is one of the key processes in planning and implementation of healthcare services. The process is important in resources limited public healthcare system in which medical technologies are normally centrally planned and implemented and healthcare policy makers and service planners are accountable for effective and efficient use of resources in meeting service demands. Technology assessment become sophisticated and challenging when complex and high cost equipment such as radiation therapy systems are involved. To achieve optimal use of public funding in healthcare, a strategy of appropriate technologies is often used in service planning and implementation. A key consideration in technology assessment is achieving optimal balance between service demand, service quality, and financial constraints. In the case of national planning and selection of radiation therapy equipment, the scope of assessment should cover more than device functionality and performance standard. Technology appropriateness and cost-effectiveness from the perspective of country specific clinical needs, service compatibility, and financial viability should also be considered. The assessment should be based on a set of country specific criteria which should include (a) technology appropriateness for disease types and staging; (b) compatibility between service capacity and service demand; (c) technology compatibility with local environmental conditions and building and building services infrastructure; (d) compatibility in quality standard and functionality with other radiation therapy and supporting equipment; (e) compatible in service standard and service volume with all relevant supporting clinical services within service clusters; (f) compatibility with the professional competence of the staff members; (g) compatibility with standard of maintenance service; and (h) national resources constraints and service sustainability. A national infrastructure should be established to develop and maintain a set of country specific technology assessment criteria and to conduct the assessment.

An increasing number of higher education institutions have started to offer courses on Medical Physics in recent years. Moreover, Continuing Professional Development (CPD) for medical physicists is of great professional interest. However, external assessment of the quality of education or training provision is needed. Accreditation is the formal recognition that education and training on medical physics provided by an institution meets acceptable levels of quality. Accreditation should be based upon standards and guidelines. Requirements for accreditation of a training programme should take into account several aspects including facilities, staff, educational material and teaching methods. The International Organization for Medical Physics (IOMP) Accreditation Board has been set up very recently to ensure that accredited medical physics programs satisfy the highest standards established by IOMP in collaboration with other international organizations. The European Federation of Organizations for Medical Physics (EFOMP) established the European Board for Accreditation in Medical Physics (EBAMP) in 2016. EBAMP accredits medical physics education and training events. In the USA, the Commission on Accreditation of Medical Physics Education Programs (CAMPEP) accredits graduate, residency and CPD programs in Medical Physics.
Certification is the recognition of knowledge of a professional who has completed his/her education or training. EFOMP has established recently its examination board (EFOMP’s Examination Board, EEB) to facilitate the harmonization of Medical Physics education and training standards throughout Europe. EEB has introduced the European Diploma of Medical Physics (EDMP) and the European Attestation Certificate to those Medical Physicists that have reached the Medical Physics Expert level (EACMPE). EEB examinations are designed to assess the knowledge, skills and competences requisite for the delivery of high standard Medical Physics services and are voluntary. The International Medical Physics Certification Board (IMPCB) has also been established to support the practice of medical physics through a certification program in accordance with IOMP guidelines.

TBA

Healthcare services landscape is changing rapidly due to multiple factors, ie healthcare economics leading to reformation in the healthcare system, major trends in public health, continuing advances in our understanding of human biology that has the potential impact on medical practice and the development of new innovative technologies for effective and precise diagnosis, treatment and monitoring. With advances in technology, how then would future healthcare and medicine look like? Would the approach gravitate towards patient-centered and personalized medicine? Particularly with the development wearables, data analytics, IoT and artificial intelligence etc. The proliferation of health centric devices and digital health will certainly give rise to connected health with increased fitness awareness. Aside from the digital revolution, multi-scale bioengineering approaches are also making impact in healthcare and medicine. In the understanding of cellular and molecular processes in pathology, and integration of computational modeling and in-vivo experimentations to address issues in tissue remodeling, injury risk prediction and device design. As such the field of medical and biological engineering has an important role to constantly attain scientific innovation and translate invention to practice, so as to enhance the healthcare interventions. Therefore, Biomedical Engineering education programme needs to address and respond to the rapid changes in technologies, teaching skills for the real world and ensuring our graduate remain relevant to the industry.

Multichannel Electroencephalography (EEG) is widely used in clinical neurology and neuroscientific research. EEG caps with wet Silver/Silver-Chloride (Ag/AgCl) electrodes represent an often-used standard in the field. Reproducible electrode-skin contact for these electrodes is ensured by electrolyte gel or paste. Thus, these electrodes require specific mechanisms to apply and hold the gel at the electrode positions in the caps and require skilled personnel to apply the EEG cap. Dry electrodes allow more degrees of freedom in the design and fabrication of EEG caps and can be self-applied without long preparation times.
This presentation introduces novel multi-channel EEG caps with dry electrodes. The base material of the EEG cap is a light-weight and flexible fabric, which contains small holes (perforation) making it breathable. Polyurethane (PU) based multi-pin electrodes serve as dry contact electrodes. A coating provides electrical conductivity of these polymer based electrodes. The use of silver coating opens the way for dry AgCl electrodes and thus, signal quality similar to wet Ag/AgCl electrodes. Thin coaxial wires are soldered to the bottom of the electrodes enabling active shielding. A second layer of fabrics protects the electrodes and the wires.
Our results demonstrate that resting state EEG, eye movements, alpha activity, and pattern reversal VEP can be recorded with the novel dry multi-channel EEG caps with short preparation time and without significant differences between the novel EEG cap and a conventional cap based on wet Ag/AgCl electrodes.
In conclusion, the proposed novel multi-channel EEG caps with dry electrodes can potentially replace conventional wet multi-channel EEG caps and thus enable new fields of application like brain-computer-interfaces and mobile EEG acquisition.

TBA

Nowadays, additive manufacturing otherwise known as three-dimensional (3D) printing is fully implemented into the production of hard tissue replacements. Department of Biomedical Engineering and Measurement together with CEIT Biomedical Engineering company designed and produced more than 45 implants made of titanium alloy using additive technologies, which were subsequently implanted by Slovak and foreign surgeons. 3D printing of PEEK, bioceramic and magnesium alloys implants is recently tested to offer alternative materials to titanium for cranioplasties or biodegradable impalnts. 3D bioprinting is being applied to regenerative medicine to address the need for tissues and organs suitable for transplantation. Compared with non-biological printing, 3D bioprinting involves additional complexities, such as the choice of materials, cell types, growth and differentiation factors, and technical challenges related to the sensitivities of living cells and the construction of tissues. The 3D bioplotter was used to prepare tubular structures made of PLA + PHB polymer for substitutes of human urethra. Tubular structures were tested from geometrical point of view to assure required precision, repeatability and possibility to print porous structures for application of epithelial and muscle cells and their growth. Several studies on PEEK spinal implants manufactured by 3D printing were realized, where mechanical testing, simulations and testing of biocompatibility were implemented. Presented research covers selected case studies of patient specific implants made by additive manufacturing and research in medical 3D bioprinting and tissue engineering.

Multi-scale computational models of organs and organ systems are being developed under the umbrella of the Physiome Project of the International Union of Physiological Sciences (IUPS) and the Virtual Physiological Human (VPH) project funded by the European Commission. These computational physiology models deal with multiple physical processes (coupled tissue mechanics, electrical activity, fluid flow, etc) and multiple spatial and temporal scales. They are intended both to help understand physiological function and to provide a basis for diagnosing and treating pathologies in a clinical setting. A long term goal of the project is to use computational modeling to analyze integrative biological function in terms of underlying structure and molecular mechanisms. It is also establishing web-accessible physiological databases dealing with model-related data at the cell, tissue, organ and organ system levels. The talk will discuss the current state of the standards, databases and software being developed to support robust and reproducible multiscale systems biology models for the VPH/Physiome project.

A Clinical Engineer is defined as “a professional who is qualified by education and/or registration to practice engineering in the health care environment where technology is created, deployed, taught, regulated, managed or maintained related to health services. Other related terms used for the CE role in developing countries include biomedical engineer and rehabilitation engineer” (http://cedglobal.org/definitions/).
I had the priviledge of chairing the Clinical Engineering Division of the International Federation for Medical Biological Engineering for three years (2015-18) and to learn a lot from the past mistakes, that often prevented this beautiful profession from achieving the world recognition that it deserves.
I will discuss the main actions taken in the last years, as well as the many skills and abilities that today’s and tomorrow’s engineers will have to master to face the new challenges that, day after day, the complex world of healthcare is preparing for us all.

Epilepsy is a debilitating brain disorder. It is characterized by epileptic seizures, spontaneously occurring disturbances of brain’s normal operation. Of the world’s 50 million people with epilepsy, fully 1/3 have seizures uncontrolled by anti-epileptic medication. Understanding the dynamics of generation of seizures (ictogenesis) could provide the foundation for new, more effective, treatment modalities. Currently, the two most promising such modalities are removal of the epileptogenic focus by surgery and control of seizures via neuromodulation. Respectively, what these modalities really need is the accurate localization of the focus and its network, and the understanding of the dynamics of ictogenesis. Monitoring and quantitative analysis of images and signals from the epileptic brain help neuroengineers towards these directions. In particular, our group has shown that, even from interictal (seizure-free) periods, it is possible to accurately localize the epileptogenic focus by analysis of electroencephalographic (EEG) and magnetoencephalographic (MEG) signals employing measures of directed information flow like the generalized partial directed coherence (GPDC). We have also shown in the past that it is possible to predict seizures with good sensitivity and specificity minutes to hours before their occurrence by employing measures from nonlinear dynamics, and to abate them with a novel feedback control scheme. Examples of focus localization and seizure prediction in humans and closed-loop seizure control in simulations and animal models of epilepsy will be presented. Therefore, the employed platform and measures are promising for identification of the topology of the pathological dynamics of neuronal networks that lead to seizures, development of biomarkers for susceptibility to seizures, timely abatement of seizures by closed-loop neuromodulation, as well as objective evaluation of the efficacy of current and new seizure treatment strategies. Broader application of this framework to other complex systems requiring monitoring, forecasting and control is a natural outgrowth of this analytical platform.

Modeling accurately biological damage induced by ionizing radiation at the scale of the DNA molecule remains a major challenge of today’s radiobiology research. In order to provide the community with an easily accessible mechanistic simulation platform, the general purpose and open source “Geant4” Monte Carlo simulation toolkit (http://geant4.org) is being extended in the framework of the “Geant4-DNA” project (http://geant4.org) with a set of functionalities allowing the detailed simulation of particle-matter interactions in biological medium. These functionalities include physical, physico-chemical and chemical processes that can be combined with nanometer size geometries of biological targets in order to predict early DNA damage. We will present an overview of the Geant4-DNA project and discuss on-going developments. User applications based on examples available in Geant4 will be shown.

A DNA double strand break (DSB) can be a lethal lesion if unrepaired but, as importantly, can lead to carcinogenesis if misrepaired. Our cells are equipped with two major DSB repair pathways as well as a signalling response that can impact upon the repair of DSBs in multiple ways. In human cells the major DSB repair pathway is DNA non-homologous end-joining (NHEJ), a simple process which allows end-processing to couple with end ligation. Homologous recombination is a more complex and elegant process that functions only in late S/G2 phase since it uses a sister chromatid as a template for repair. In human cells, the upstream components of NHEJ (the DNA-PK complex, involving Ku and DNA-PKcs) are highly abundant and have exquisite end-binding capacity. Hence, Ku is usually the first protein to bind to DNA ends and NHEJ is the favoured pathway. Even after high doses, NHEJ is highly efficient in its capacity to rejoin DSBs. An important issue, however, is the fidelity with which the DSBs are rejoined. Indeed, evidence suggests that misrepaired DSBs rather than unrepaired IR-induced DSBs are a major cause of cell death. If the DSB is complex involving sequence loss from both DNA strands then the lost sequences cannot be regained during NHEJ, and deletions at the junction will arise. Current evidence also suggests that a component of NHEJ involves resection of the DNA ends, which also has the potential to cause small deletions at the junctions. Additionally, and importantly in the context of radiotherapy, NHEJ has the capacity to rejoin the incorrect DNA ends, leading to the formation of translocations. This appears to arise at a frequency that increases exponentially with dose. The signalling response to DSBs involving the ATM kinase serves to restrict incorrect end-joining, thereby promoting accurate rejoining. I will discuss the processes of DSB rejoining, focusing on the two distinct components of NHEJ and its interface with the signalling response. I will discuss the limitations of NHEJ underlying incorrect end-joining and the mechanism by which ATM-dependent signalling helps to counteract these weaknesses inherent to NHEJ.

Recently, the massive explosion of medical evidence on the Internet and mobile devices and increased citizens’ involvement in management of their health changed the delivery of healthcare. This rapid process changed healthcare delivery at developed world and increasingly improves community health in the low and middle income countries (LMIC).
In this presentation we will outline the issues surrounding the dissemination of medical evidence and understanding public information needs from Internet search weblogs analytics. Educational effectiveness of serious games highlights the opportunity mobile technology brought to training, community engagement and behaviour change. Social networking with increasing amount of user-generated content from social media and participatory surveillance systems provide readily available source of real-time monitoring and epidemic intelligence.
In this talk, we will draw from several mobile technology projects aimed at citizens in low and middle income countries. In particular, mobile training and crowdsourcing for community engagement to combat the zika virus in Brazil, social media use for vaccination campaigns, early warning epidemics dashboard, and serious mobile games for increasing resilience and disaster preparedness in perinatal women in Nepal.

Biologists and physicians have to be able to rely on the correctness of results obtained by automatic analysis of biomedical images. This, in turn, requires paying proper attention to quality control of the developed algorithms and software for this task. Both the medical image analysis and bioimage analysis communities are becoming increasingly aware of the strong need for benchmarking various image analysis methods in order to compare their performance and assess their suitability for specific applications. Reference benchmark datasets with ground truth (both simulated and real data annotated by experts) have become publicly available and challenges (competitions) are being organized in association with well-known conferences, such as ISBI and MICCAI (https://grand-challenge.org/).
This talk summarizes recent developments in this respect and describes common ways of measuring algorithm performance as well as providing guidelines for best practices for designing biomedical image analysis benchmarks and challenges, including proper dataset selection (training versus test sets, simulated versus real data), task description and defining corresponding evaluation metrics that can be used to rank performance.
Proper benchmarking of image analysis algorithms and software makes life easier not only for future developers (to learn the strengths and weaknesses of existing methods) but also for users (who can select methods that best suit their particular needs). Also reviewers can better assess the usefulness of a newly developed analysis method if it is compared to the best performing methods for a particular task on the same type of data using standard metrics.

Most contrast in conventional MRI arises from differences in T1 relaxation time. Studies on small tissue samples have shown that extra information could be obtained from T1-dispersion (plots of T1 versus magnetic field strength), but this information is invisible in conventional MRI since scanners operate at fixed magnetic field (e.g. 1.5 T). We are developing Fast Field-Cycling Magnetic Resonance Imaging (FFC-MRI) to exploit T1-dispersion as a new biomarker, with the aim of increasing diagnostic potential.
FFC measures T1-dispersion by switching the magnetic field rapidly between levels during the pulse sequence, with relaxation occurring at the “evolution” field (usually a low value) and always returning to the same “detection” magnetic field (a higher value) for NMR signal measurement. FFC-MRI obtains spatially-resolved T1-dispersion data, by collecting images at a range of evolution magnetic fields.
We have built two whole-body human sized scanners, operating at detection fields of 0.06 T [3] and 0.2 T. The 0.06 T device uses a double magnet, with field-cycling being accomplished by switching on and off a resistive magnet inside the bore of a permanent magnet; this has the benefit of inherently high field stability during the detection period. The 0.2 T FFC-MRI system uses a single resistive magnet which has the advantage of increased flexibility in pulse sequence programming, at the expense of lower field stability during the detection period, necessitating more complex instrumentation.
We are investigating a range of applications of FFC relaxometry and FFC-MRI. Our work has demonstrated that FFC relaxometry can detect the formation of cross-linked fibrin protein from fibrinogen in vitro, through the measurement of 14N-1H cross-relaxation phenomena, known as “quadrupolar dips”. We have also shown that FFC-MRI can detect changes in human cartilage induced by osteoarthritis. Recent work has focused on speeding up FFC-MRI by incorporating rapid MRI scanning methods.

Different types of analysis of the surface electrocardiogram have been proposed for evaluating the effects of antiarrhythmic drugs, such as: heart rate variability, QT-dispersion, ST-segment or QRS-Morphology. A decade or so ago, new research began to appear on atrial antiarrhythmic drug effects, thanks to novel techniques for quantifying parameters related to atrial activity that commonly go overlapped by ventricular activity. Such techniques include analysis in terms of atrial fibrillatory rate and its variability, spectral characterization of fibrillatory waves during AF, P-wave signal averaged ECG during sinus rhythm among others.
This presentation analyzes how these techniques are being applied to a new field of study such as cardioversion drugs, providing knowledge on how they can act non-invasively and analyzing the evolution of atrial dominant frequency together with other parameters in the spectrum (spectral concentration, second peak ratio, harmonics, etc.), observing the different behaviors associated with their effectiveness. In order to validate the information obtained non-invasively, the analysis shows a comparison between the parameters obtained through the ECG analysis and those obtained through a duo-decapolar catheter during an electrophysiology study, in which both recordings are obtained simultaneously. Much of the information can be obtained through advanced analysis of the ECG signal, although asynchrony and heterogeneity continue to be difficult to obtain. Ultimately, these advances can contribute to overcoming today’s challenging clinical questions in AF management.

Health Technology Assessment (HTA) aims to inform healthcare decisions regarding appropriate innovative health technologies. After many years in which HTA community focused mainly on drug assessment, the attention of HTA international community is returning on medical devices, given their growing diffusion, increasing complexity and associated costs.
This talk will report on challenges and gaps met while assessing medical devices suggesting, when relevant, possible solutions.
Since 2014, the Applied Biomedical Signal Processing and Intelligent eHealth (ABSPIeH) Lab at the University of Warwick, directed by Dr Pecchia, focused on peculiar aspects of medical devices, and relevant scientific literature, which affect their assessment. For instance, in a recent study, the ABSPIeH lab demonstrated that even the positioning of a sensor, may affect the significance of a test based on medical devices. In a different study, performing field analysis in Sub-Saharan Africa, ABSPIeH lab tried to quantify the extent of which HTA reports can be reliable when assessing safety or effectiveness of medical devices in low income countries.
This talk will report on those experiences and will conclude presenting the significant effort made by the ABSPIeH, in cooperation with the IFMBE HTAD and the WHO, in order to produce pragmatic teaching material and guidelines on HTA of medical devices, which was designed specifically to meet the needs of medical physicists and biomedical engineers scientific communities.

Getting access and analyzing data is the driving force behind all progress in business today. This is also true in healthcare. Patient records hold the information for their current care and there is now intercommunication between heath systems to link data and create a complete patient electronic medical record (EMR). This requires robust security measures to ensure records are only accessible by people that should be accessing them. It also requires a dependable methodology to ensure the correct patient data is linked together.
Once you have the compete patient’s EMR it can still be difficult to find the needed data because there is often a lot of extraneous information that may hide what a clinician needs. So how do you find the relevant data? In addition, the data is often unstructured or there are structured and unstructured data combined. Consequently, an intelligent method to search and combine this data is needed. The EMR also needs to have a reliable method for updating personnel when critical findings are added to the EMR. But who should get this notification and how do you minimize notification overload? Also, how do you link a clinical recommendation to a result? This can make sure a patient’s care is done in a timely manner, but also provides data on outcomes that can increase the ability to determine the best treatment courses. In addition, there is much more data that needs to be accessible by clinicians to make the right decisions on care. Clinicians need to know all the latest advances and what experts in each area recommend.
This is just a small portion of things that are being done or are needed in medical informatics. A review of some of the methods that are being used to gather and analyze medical data will be presented.

The presentation will introduce IAEA standards of safety for protection of health and minimization of danger to life and property so called International Basic Safety Standards on Radiation Protection and Safety of Radiation Sources (BSS), and advancements with their application in the radiations radiation safety systems. The first BSS were published in 1962 and have been revised and updated since then. The latest version which was approved in September 2011 and published in 2014, is jointly sponsored by seven other international organizations. It applies to all situations involving exposure due to radiation, whether of natural or artificial origin. As such, they are universally applicable to the protection of people in all exposure situations. In order o ensure consistency in the radiation protection system and in regulatory frameworks worldwide, BSS follow ICRP recommendations, in particularly designation of situations of exposure in accordance with ICRP Publication 103 - ‘planned exposure situations’, ‘emergency exposure situations’ and ‘existing exposure situations’, as well as introduce recommended revised reduced dose limits to the lens of the eyes. The presentation will also address three existing or foreseen challenges namely (1) need to address dose coefficients per unit exposure to radon and radon progeny which are being prepared by ICRP and UNSCEAR, (2) application of the concepts of exclusion, exemption, and clearance, and (3) food drinking water safety related to the presence of natural and artificial radionuclides. In the last part, the presentation will discuss specific challenges that were highlighter in the aftermath of the TEPCO Dai-ichi NPP accident in Japan, particularly radiation protection of workers in elevated exposure situations and communication of radiation protection measures with non-expert parties.

In the US alone, there are approximately 650,000 new pacemaker (PM) and Implanted Cardio Defibrillator (ICD) procedures per year, with a projected growth rate of 15% per year. There is roughly a 50% chance of an indication for MRI in a PM/ICD patient over their lifetime.
MR Safe pacemakers came onto the market in 2011, but the patient population will continue to have MR “Unsafe” PMs and ICDs for many years. Remnants of the devices, such as abandoned pacemaker leads, will continue for some patients’ lifetimes and the number of patients needing MRIs will increase as the population ages. Despite the growing patient population, many hospitals still view the presence of PMs/ICDs as a contraindication for MR imaging, particularly of the thorax. Until recently, even some academic centers in the US have opted not to scan such patients or to limit their scanning to modalities other than MRI.
In this presentation, current literature and general recommendations of scientific and professional societies as well as regulatory bodies in the US and Europe will be reviewed. The Medical University of South Carolina (MUSC), an Academic Center for the Southeast of the United States has been scanning such patients for several years. This undertaking is an example of the use of a teamwork approach to hospital policy, an approach in which members of different disciplines and different departments work in concert to meet the medical and safety challenges of relatively new medical issues. Specific procedures, guidelines for pulse sequences, Specific Absorption Rate, electronic lead configuration, review of vendor information, and the steps for medical approval followed at MUSC will be presented.

Safety is a key factor, next to expected effectiveness, which characterizes quality of a medical device. Safety of medical devices became a big topic after the PIP scandal and as consequence, the authorities started to put more focus on strict and precise compliance with the requirements.
On the other hand, when putting a medical device on the market, the main goal is to safeguard the public health and to offer an effective and no compromizing therapy or diagnose. Therefore, it is crucial that manufacturers are complying with these requirements to highest possible level during the whole lifecycle of the device.
In the presentation, different aspects of safety of medical device will be discussed and also a short overview of safety requirements in the new regulations will be presented.

The academic and clinical impact of extracellular microelectrode-arrays (MEA) neuroengineering technologies exceeded all expectations. Today's brain-machines interface technologies (BMIs) enable to replace sensory organs, connect robotic parts to the PNS or CNS, link disrupted neuronal pathways, sense pathological firing patterns and generate stimuli to modulate them, inject drugs and suppress pain. Under in vitro conditions similar technologies are used to screen drugs using cultured human pluripotent stem cells taken from healthy subjects and patients to develop advanced personalized medicine.
Nevertheless, even the most sophisticated MEA used nowadays suffer from critical drawbacks such as poor signal to noise ratio, inadequate source resolution and instabilities overtime. These sever shortcomings are attributed mainly to the nature of the interfaces formed between living cells and the MEA devises.
In the presentation I will review the field focusing on novel breakthrough bioengineering approaches to generate the next generation neurons/cardiomyocytes-MEA interfaces to overcome the present shortcomings.

Various Organizations such as the International Commission on Radiological Protection (ICRP), the International Atomic Energy Agency the European Commission, the Food and Drug Administration and others draw our attention to interventional Radiology (IR) procedures as high radiation dose techniques with elevated risk for various tissue effects. This is due to the use of either fast multi-detector CT (MDCT) scanners or highly sophisticated fluoroscopic equipment such as angiography machines to best localize the lesion or the treatment site. The machines are used to continuously monitor and record these procedures. The most important tissue injuries affect the skin and the eye lens. They usually appear within 7-14 days of exposure. They may be acute or chronic and a certain threshold is required. The radiation dose threshold can be reached either from a single IR technique or from cumulative radiation doses by successive IR procedures. Several papers reported skin injuries following IR the last 20-30 years, especially after percutaneous coronary interventions, neuroembolisations or other complex techniques. Possible effects include inflammation of skin, presenting as erythema or pain that may later transform into ulceration, atrophy, telangiectasia, sclerosis, discoloration and other effects. Cardiologists, angiosurgeons, interventional radiologists, gastroenterologists or other medical specialties performing these techniques are frequently unaware of the high radiation doses to which a patient's skin may be subjected, even with the use of modern, state of the art equipment. This paper will review current knowledge, techniques and possible regulatory requirements necessary to prevent radiological skin injuries from the medical physicist point of view. Practical advices will be given from the same perspective on how to avoid them by simple steps.

An ideal quantitative method should be reproducible (if repeated at a different time, using a different camera and software), with known reference range for the result which is preferably unified – that is, dependent on the fewest factors possible. Steps of the process include image acquisition, reconstruction, followed by arithmetic, physical and biological phases of processing, providing simple static measures, indices of changes, or parameters of model fitting.
Emission imaging (by gamma camera or PET) is inherently deteriorated by noise, attenuation, scatter, limited and position-dependent resolution, and physiological motion (heart beat and respiration). All these factors should be addressed to obtain the most accurate, precise and biologically meaningful results possible. We shall review the methods for, and limitations of SPECT and PET reconstruction with the embedded correction steps, and the principles how image quality may be measured and optimized.
Hybrid imaging and multimodality image processing, while offering the potential for improving our accuracy, may introduce additional sources of error, originating from misalignment, different circumstances, and propagating artifacts.
Take-home message of the review is that when utilizing sophisticated image processing algorithms, we should always be aware of the possible sources of error, and carefully validate the methods before introducing them to our clinical or research work.

Starting with a quick discussion of Biohacking, implants connected into the brain can be employed both for therapeutic purposes and also for enhancement. Here a look is taken at present and future uses of cochlea implants, visual neuroprosthetics and deep brain stimulation. Also considered is the possibility of growing brains by culturing neurons and through a process of embodiment thereby learning about structures and possible treatments. Finally the BrainGate implant is investigated not only for therapeutic uses but also for the enhancement of human brain and nervous system functioning, in order to create new, improved, forms of communication and to extend the human nervous system via a network, thereby allowing for an individual’s brain and body to be in totally different places.

Spearheaded by IOMP and IUPESM since four decades ago, the language was finally placed in the International Labour Office’s list of occupations to define the occupation of Medical Physicist. It was a major milestone marked by IUPESM Past President Keith Boddy (1937-2010). The International Standard Classification of Occupations (ISCO-08) was finalized in 2008 before the publication of the IOMP Policy Statements in 2010. The subsequent monumental harmonizing task of IAEA has made it possible for the medical professionals to harness the highly sophisticated medical technologies in every part of the world with the help of medical physicists, whose job title did not exist in hospitals in many countries, let alone the job descriptions. The International Medical Physics Certification Board (IMPCB), in the middle of the historical development, had to emerge to help the movement in a credible way, by setting up a system to identify qualified medical physicists. The IOMP again was the driving force behind it. Soon after the incorporation of the organization, IOMP became the Principle Supporting Organization when the Memorandum of Understanding was signed during the World Congress 2016. Among the many objectives stated in the bylaws of IMPCB, the tasks of accreditation of national and regional certification boards and direct certification of individual medical physicists are most visible. In this presentation, the speaker will present the process and recent updates of the accreditation efforts, and the preliminary statistics of the examinations. The speaker will acknowledge the current developments in radiation medicine, and explore the challenges faced by medical physicists. With the goal of preparing the qualified medical physicists to face the future, the speaker will summarize with a list of actions for IMPCB to take in order to uphold the standard globally for the not too distant future.

Surgical robotics has made big strides in the last decade in technological innovation and clinical translation, supporting our pursuit in precision medicine, personalised healthcare, and quality-of-life improvements. The successes of the first-generation clinical systems have inspired an ever-increasing number of platforms from both commercial and research organisations, resulting in smaller, safer, and smarter devices. This lecture will look back through the last 25 years at how surgical robotics has evolved to a major area of innovation and development. With improved safety, efficacy and reduced costs, robotic platforms will soon approach a tipping point, moving beyond early adopters to become part of the mainstream surgical practice. These platforms will also drive the future of precision surgery, with a greater focus on early intervention and quality of life after treatment. Issues related to regulatory, ethical, and legal considerations for increasing levels of autonomy will be discussed. The lecture will also illustrate how this relatively young yet rapidly expanding field may reshape the future of medicine, as well as the associated technical, commercial, and economic challenges that need to be overcome.

PET has, since its inception, established itself as the imaging modality of choice for the in vivo quantitative assessment of molecular targets in a wide range of biochemical processes underlying tumour physiology. PET image quantification enables to ascertain a direct link between the time-varying activity concentration in organs/tissues and the fundamental parameters portraying the biological processes at the cellular level being assessed. However, the quantitative potential of PET may be affected by a number of factors related to physical effects, hardware and software system specifications, tracer kinetics, motion, scan protocol design and limitations in current image-derived PET metrics. Given the relatively large number of PET metrics reported in the literature, the selection of the best metric for fulfilling a specific task in a particular application is still a matter of debate. Quantitative PET has advanced elegantly during the last two decades and is now reaching the maturity required for clinical exploitation, particularly in oncology where it has the capability to open many avenues for clinical diagnosis, assessment of response to treatment and therapy planning. Therefore, the preservation and further enhancement of the quantitative features of PET imaging is crucial to ensure that its full clinical value is utilized in clinical oncology. The bulk of PET/MR research to date focused on the instrumentation and building MR-compatible PET detectors and readout technologies, the challenges of MRI-guided PET attenuation correction, partial volume correction and motion compensation, and also finding a niche or primary clinical use of PET/MRI. This talk reflects the tremendous increase in interest in quantitative molecular imaging using PET/MRI hybrid imaging in both clinical and research settings. Quantitative imaging biomarkers will help in charting personalized treatment plans for patients and also in exploring new therapeutic opportunities. Current and prospective future applications of quantitative molecular imaging using PET/MRI will be addressed.